Health

Psoriasis: the reality of this common disease of the skin

Psoriasis is a common disease of the skin, which can take many forms. What are the symptoms, how can you identify psoriasis, and what treatments will cure it? Read this article and discover the reality behind these itchy and scratchy red patches.

Joelle

What is psoriasis?

Psoriasis is an autoimmune disease of the skin that afflicts around 3% of the population. This means it is a disease in which your own immune system mistakes a part of your body for a threat and start attacking it. In the case of psoriasis, they turn against parts of your skin and cause various symptoms.

Patients afflicted with this illness typically develop plaques: patches of abnormal skin, typically red or purple. These plaques can vary a lot:

they can cover a small patch of skin or cover the entire body
the skin around these patches can turn red, itchy or even scaly
plaques can appear in any location on the body but are more typical on areas like the elbows, the knees or the scalp

Different types of psoriasis?

Different forms of psoriasis – Source: VeryWell Health

The most common form of the disease is plaque psoriasis, by far: up to 90% of patients are diagnosed with this type.

But there are other types of psoriasis:

Pustular psoriasis: patients develop pustules (elevation of the skin), filled with non-infectious liquid
Inverse psoriasis: typically affects skin folds like around the genitals, the armpits or under the breasts
Napkin psoriasis: common in infants, it causes scaling in the diaper area
Guttate psoriasis: small droplet-like spots appear on the body
Erythrodermic psoriasis: widespread inflammation and scaling – this form of the disease often affects over 90% of the body
Mouth psoriasis: although very rare, psoriasis can affect the mouth, appearing as grey or yellowish plaques
Nail psoriasis: rarely found separately, this form of the disease specifically targets nails, which become harder than usual and can therefore crack, break or even separate from the nail bed

Do not scratch these plaques!

In fact, it is even a medical sign, quite typical of the ailment: when you scratch or even scrape off these plaques, they start bleeding in a particular fashion. Indeed, the bleeding is extremely localized, appearing to be more like small points of blood than usual bleeding.

Are there other symptoms associated?

Short answer: yes. Long answer: not really. Psoriasis is really characterized by its dermatological lesions and few symptoms are associated:

itching
pain
burning
swollen joints
thickened or cracked nails (especially in case of nail psoriasis

You should know these symptoms are not necessarily present in each patient. Actually, most patients suffer only from dermatological lesions.

What causes psoriasis?

Although the cause of this skin condition is not fully understood, a number of theories exist.

Is it contagious?

First of all, no reason to take particular precautions around someone afflicted with psoriasis: this disease is absolutely not contagious. Since it is an autoimmune disease, there are no pathogens (bacteria, toxins, or viruses) involved. Therefore, the disease is unable to spread to another person.

What about the role of genetics?

Psoriasis is not really a genetic disease. Although researchers have identified genes associated with the condition, there is no gene actually causing it directly.

Nevertheless, it is clear that genetics play their part. For instance, if a twin has psoriasis, the other one has a 70% chance to develop it as well, proving that the disease does have a genetic component, but not a direct one.

Can your lifestyle affect or cause psoriasis?

There are a lot of lifestyle factors that can worsen your condition but none of them are a direct cause:

chronic infections (especially dermatological infections)
stress
smoking
excessive alcohol consumption
climate
skin dryness
obesity

Does medication play a role?

A lot of drugs can worsen or even induce psoriasis:

beta-blockers
lithium
antimalarial medication
non-steroidal anti-inflammatory drugs (like aspirin or paracetamol)
interferons
lipid-lowering drugs

How does psoriasis develop?

Patients afflicted with psoriasis have abnormal skin: the upper layer of the skin (called the epidermis) overdevelops and skin cells that normally reproduce in a month’s time are replaced within a week.

This overabundance of skin cells is responsible for all symptoms and is the consequence of the autoimmune reaction: white blood cells move from the dermis (where they are normally located) to the epidermis and start producing proteins (like interleukin-6) which stimulate skin production.

Also, dying cells produce the same proteins, aggravating the process and causing the already abnormal skin production to increase even further.

What treatment?

Although there is no definite cure yet, several treatments can be proposed.

What are topical preparations?

Topical creams (local creams) are the most common treatment. Most of them contain corticosteroids (like cortisone) to reduce inflammation and its consequences. Physicians also often prescribe vitamin D (and similar molecules) creams in association with corticosteroids to enhance their effects.

To combat dryness of the skin and scaling, most treatments include moisturizers and emollients to hydrate and soften the skin. In that case, the most common treatments are mineral oil and petroleum jelly.

Phototherapy

Phototherapy is another common treatment. It consists of exposing the part of the affected skin to UV rays. This type of therapy not only has its own beneficial effects, but it also enhances the effects of topical creams including vitamin D.

Balneotherapy

Balneotherapy involves treatments through frequent bathing. The Dead Sea is famous for this form of treatment since its water is naturally rich in salt. Also, patients benefit from a bit of sunlight and get the benefits from both balneotherapy and phototherapy.

Immune system suppressants

As mentioned earlier, psoriasis is a disease in which the immune system turns against the patient’s own body. Therefore, medications that prevent this from happening are a very effective way to treat it.

Molecules such as methotrexate, ciclosporin, or fumarates are common drugs in therapy against this condition. In fact, they are even the first line of treatment in some forms of erythrodermic psoriasis.

Psoriasis, a good reason to consult!

Psoriasis is a common disease of the skin, which can take many forms. Although it has genetic factors, it is a multifactorial disease (a disease that has multiple causes). Although severe, it is relatively easy to control with proper medication.

So if you notice red plaques on your body, that can be itchy or scaly, consult a physician or a dermatologist, as you might be having this fairly common disease of the skin.